Digestive Diseases and Sciences

, Volume 59, Issue 2, pp 482–488

Granulocytapheresis for the Treatment of Severe Alcoholic Hepatitis: A Case Series and Literature Review

  • Kenya Kamimura
  • Michitaka Imai
  • Akira Sakamaki
  • Shigeki Mori
  • Masaaki Kobayashi
  • Ken-ichi Mizuno
  • Manabu Takeuchi
  • Takeshi Suda
  • Minoru Nomoto
  • Yutaka Aoyagi
Case Report

Abstract

Severe alcoholic hepatitis has a high mortality rate due to limited therapeutic methods. Although corticosteroids have been used to control the inflammatory response, the outcomes vary and no standardized therapy has been established. Novel therapeutic approaches, such as anti-TNF-α, pentoxifilline, and others have been tested clinically on the basis of their cytokinemic pathophysiology with limited success. However, treatment of leukocytosis that causes cytokinemia and hepatic inflammation in patients via granulocytapheresis and leukocytapheresis showed promising results in a number of reports. Here, we report two cases of severe alcoholic hepatitis treated with granulocytapheresis. The liver function and inflammation recovered after the therapy. A review of 35 cases treated with granulocytapheresis and leukocytapheresis demonstrated their efficacy in treating alcoholic hepatitis by controlling leukocytosis as well as cytokines such as IL-8. Multidisciplinary treatment for severe alcoholic hepatitis should be considered case by case on the basis of the complexity and severity of the condition.

Keywords

Severe alcoholic hepatitis Granulocytapheresis Leukocytapheresis IL-6 IL-8 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Kenya Kamimura
    • 1
  • Michitaka Imai
    • 1
  • Akira Sakamaki
    • 1
  • Shigeki Mori
    • 2
  • Masaaki Kobayashi
    • 1
  • Ken-ichi Mizuno
    • 1
  • Manabu Takeuchi
    • 1
  • Takeshi Suda
    • 1
  • Minoru Nomoto
    • 1
  • Yutaka Aoyagi
    • 1
  1. 1.Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata UniversityChuo-kuJapan
  2. 2.Department of Gastroenterology and HepatologyShinrakuen HospitalNishi-kuJapan

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